AB1634 RISK FACTORS ASSOCIATED WITH PARCIAL OR NULL REMISSION OF RENAL ACTIVITY IN PATIENTS WITH LUPUS NEPHRITIS
Authors: A. Martínez Badajoz, J. R. Hernández Vásquez, M. Ocampo Torres, A. Ramirez Pérez, A. Camargo, F. M. Bravo Rojas, J. Hernandez Rivera
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune chronic disease, the severity of organic involvement depends on factors such as sex, race and age of disease presentation. Lupus nephritis is present in up to 40% of patients with SLE. Failure to achieve complete remission at 6 months is associated with a poor long-term prognosis and implies greater use of immunosuppressants. <h3>Objectives</h3> To determine the factors associated with the parcial or null remission in patients with lupus nephritis. <h3>Methods</h3> A nested case-control study was conducted in a retrospective cohort of patients with lupus. Fifty-five patients with renal involvement were included and divided into two groups, those with partial or no remission in response to remission induction (n=30) and those with complete remission (n=25), multiple factors were analyzed and in the case of quantitative variables they were categorized into 2 groups with specific cut-off points in each case. The type of remission of each patient was taken as a factor to be analyzed and the analysis was completed in a bivariate logistic regression with a significance &lt;0.05. <h3>Results</h3> The variables that showed risk of presenting a partial or null response were: not having completed the minimum time of 6 months of the remission induction scheme (Odds Ratio [OR]: 9.590; 95% Confidence Interval [95% CI]: 2.351-39.119; <i>p</i>=0.002), sex male (OR: 8.727; 95% CI: 1.009-75.51; <i>p</i>=0.049); start Renal Replacement Therapy (RRT) (OR: 8.727; 95% CI 1.009-75.513; <i>p</i>=0.049); family history of SLE (OR: 7.304; 95% CI: 0.832-64.098; <i>p</i>=0.073); have a Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) ≤60 ml/min/1.73m<sup>2</sup> (OR: 6.147; 95% CI: 1.577-26.110; <i>p</i>=0.009); Creatinine ≥1.2 mg/ dL (OR: 6.000; 95% CI: 1.767-20.369; <i>p</i>=0.004); C-Reactive Protein (CRP) ≥5g/dL (OR: 5.470; 95% CI: 1.680- 17.811; <i>p</i>=0.005); age ≤30 years (OR: 4.250; 95% CI: 1.370-13.188; <i>p</i>=0.012); proteinuria ≥1.5 g/24 hours (OR: 3.560; IC 95%: 1.123-11.285; <i>p</i>=0.31). <h3>Conclusion</h3> The factors observed that are associated with a partial or null remission were: not completing the remission induction scheme, male sex, start with RRT, CKD-EPI ≤60ml/min/1.73m<sup>2</sup>, creatinine ≥1.2mg/dL, CRP ≥5g/dL, age ≤30 years and proteinuria ≥1.5g/24 hours. On the other hand, factors such as a family history of SLE, BMI ≥30kg/m<sup>2</sup> and hemoglobin ≤10g/dl although they demonstrated an association, the values weren't statistically significant. These factors make it possible to identify areas of interest when starting remission induction therapy, demonstrating the importance of therapeutic adherence and individualized follow-up for each patient, offering timely intervention in modifiable factors and close monitoring of patients with non modifiable factors. <h3>References</h3> [1]Pinto LF. et al. (2014). Predictive risk factors for failure to induction therapy of lupus nephritis in a cohort of Colombian patients. Clinical Rheumatology, 10(3), 147–151. [2]Gasparotto, M. et al. (2020). Lupus nephritis: clinical presentations and outcomes in the 21st century. Rheumatology (Oxford, England), 59(Suppl5), v39–v51. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.